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1.
J. Hypertens ; 37(9): 1813-1821, Jul., 31, 2019. ilus, tab
Artigo em Inglês | Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1015823

RESUMO

OBJECTIVES: The objective is to describe hypertension (HTN) prevalence, awareness, treatment and control in urban and rural communities in Latin America to inform public and policy-makers. METHODS: Cross-sectional analysis from urban (n = 111) and rural (n = 93) communities including 33 276 participants from six Latin American countries (Argentina, Brazil, Chile, Colombia, Peru and Uruguay)were included. HTN was defined as self-reported HTN on blood pressure (BP)medication or average BP over 140/90 mmHg, awareness as self-reported HTN, and controlled as those with BP under 140/90 mmHg. RESULTS: Mean age was 52 years,60% were Female and 32% belonged to rural communities. HTN prevalence was 44.0%, with the lowest rates in Peru (17.7%) and the highest rates in Brazil (52.5%)58.9% were aware of HTN diagnosis and 53.3% were receiving treatment. Prevalence of HTN were higher in urban (44.8%) than rural (42.1%) communities in all countries. Most participants who were aware of HTN were receiving medical treatment (90.5%), but only 37.6% of patients receiving medical treatment had their BP controlled (<140/<90 mmHg), with the rates being higher in urban (39.6%) than in rural (32.4%) communities. The rate of use of two or more drugs was low [36.4%, lowest in Argentina (29.6%) and highest in Brazil (44.6%)]. Statin use was low (12.3%), especially in rural areas (7.0%). Most modifiable risk factors were higher in people with HTN than people without HTN. CONCLUSION: HTN prevalence is high but BP control is low in Latin America, with marked differences between countries and between urban and rural settings. There is na urgent need for systematic approaches for better detection, treatment optimization and risk factor modification among those with HTN in Latin America.(AU)


Assuntos
Humanos , Hipertensão/epidemiologia , América Latina/epidemiologia
2.
Artigo em Espanhol, Português | PAHO-IRIS | ID: phr--51081

RESUMO

[EXTRACTO]. Uno de los objetivos principales de la Política de investigación para la salud de la Organización Panamericana de la Salud (OPS) es establecer alianzas con el fin de ejecutar estrategias de salud apropiadas y sostenibles. Esta política procura facilitar el desarrollo y la disponibilidad a mayor escala de productos y tecnologías asequibles y accesibles pertinentes para la respuesta a los retos de salud pública de la Región de las Américas; crear grupos de investigación en los Estados Miembros de la OPS con competencias que permitan el intercambio de los conocimientos procedentes de la investigación; y promover la colaboración entre los diversos interesados directos, incluidos el público general, el gobierno y los sectores académico y privado a fin de hacer frente a las prioridades nacionales y regionales...


[EXTRACTO]. Um dos principais objetivos da política de pesquisa para a saúde da Organização Pan-Americana da Saúde (OPAS) é o desenvolvimento de parcerias para implementar estratégias de saúde adequadas e sustentáveis. A política visa facilitar o desenvolvimento e a ampliação de produtos e tecnologias econômicos e acessíveis que sejam relevantes para as necessidades de saúde pública nas Américas, estabelecer grupos de pesquisa nos Estados Membros da OPAS com competências que permitam o intercâmbio de conhecimentos e facilitar a colaboração entre as diversas partes relevantes – incluindo os setores público, governamental, acadêmico e privado – para abordar as prioridades nacionais e regionais...


Assuntos
Pesquisa sobre Serviços de Saúde , Política de Pesquisa em Saúde , Américas , Pesquisa sobre Serviços de Saúde , Política de Pesquisa em Saúde
3.
J Hypertens ; 37(9): 1813-1821, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30964825

RESUMO

OBJECTIVES: The objective is to describe hypertension (HTN) prevalence, awareness, treatment and control in urban and rural communities in Latin America to inform public and policy-makers. METHODS: Cross-sectional analysis from urban (n = 111) and rural (n = 93) communities including 33 276 participants from six Latin American countries (Argentina, Brazil, Chile, Colombia, Peru and Uruguay) were included. HTN was defined as self-reported HTN on blood pressure (BP) medication or average BP over 140/90 mmHg, awareness as self-reported HTN, and controlled as those with BP under 140/90 mmHg. RESULTS: Mean age was 52 years, 60% were Female and 32% belonged to rural communities. HTN prevalence was 44.0%, with the lowest rates in Peru (17.7%) and the highest rates in Brazil (52.5%). 58.9% were aware of HTN diagnosis and 53.3% were receiving treatment. Prevalence of HTN were higher in urban (44.8%) than rural (42.1%) communities in all countries. Most participants who were aware of HTN were receiving medical treatment (90.5%), but only 37.6% of patients receiving medical treatment had their BP controlled (<140/<90 mmHg), with the rates being higher in urban (39.6%) than in rural (32.4%) communities. The rate of use of two or more drugs was low [36.4%, lowest in Argentina (29.6%) and highest in Brazil (44.6%)]. Statin use was low (12.3%), especially in rural areas (7.0%). Most modifiable risk factors were higher in people with HTN than people without HTN. CONCLUSION: HTN prevalence is high but BP control is low in Latin America, with marked differences between countries and between urban and rural settings. There is an urgent need for systematic approaches for better detection, treatment optimization and risk factor modification among those with HTN in Latin America.

4.
Nutrients ; 10(11)2018 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-30360485

RESUMO

Peru is undergoing a nutrition transition and, at the country level, it faces a double burden of disease where several different conditions require dietary changes to maintain a healthy life and prevent complications. Through semistructured interviews in rural Peru with people affected by three infectious and noninfectious chronic conditions (type 2 diabetes, hypertension, and neurocysticercosis), their relatives, and focus group discussions with community members, we analyzed their perspectives on the value of food and the challenges of dietary changes due to medical diagnosis. The findings show the various ways in which people from rural northern Peru conceptualize good (buena alimentación) and bad (mala alimentación) food, and that food choices are based on life-long learning, experience, exposure, and availability. In the context of poverty, required changes are not only related to what people recognize as healthy food, such as fruits and vegetables, but also of work, family, trust, taste, as well as affordability and accessibility of foods. In this paper we discuss the complexity of introducing dietary changes in poor rural communities whose perspectives on food are poorly understood and rarely taken into consideration by health professionals when promoting behavior change.

7.
BMJ Glob Health ; 1(3)2016.
Artigo em Inglês | MEDLINE | ID: mdl-27840737

RESUMO

Low and middle income countries (LMICs) bear a huge, disproportionate and growing burden of cardiovascular disease (CVD) which constitutes a threat to development. Efforts to tackle the global burden of CVD must therefore emphasise effective control in LMICs by addressing the challenge of scarce resources and lack of pragmatic guidelines for CVD prevention, treatment and rehabilitation. To address these gaps, in this analysis article, we present an implementation cycle for developing, contextualising, communicating and evaluating CVD recommendations for LMICs. This includes a translatability scale to rank the potential ease of implementing recommendations, prescriptions for engaging stakeholders in implementing the recommendations (stakeholders such as providers and physicians, patients and the populace, policymakers and payers) and strategies for enhancing feedback. This approach can help LMICs combat CVD despite limited resources, and can stimulate new implementation science hypotheses, research, evidence and impact.

8.
PLoS One ; 11(9): e0162614, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27626274

RESUMO

AIM: Glycated haemoglobin (HbA1c), a marker of glucose control in individuals with diabetes mellitus, is also related with the incidence of cardiometabolic risk in populations free of disease. The aim of this study was to describe the distribution of HbA1c levels according to early-life and contemporary factors in adolescents and adults without diabetes mellitus. METHODS: HbA1c was measured in adults aged 30 years and adolescents aged 18 years who are participants in the 1982 and 1993 Pelotas Birth Cohorts, respectively. Bivariate and multivariate analyses were performed to describe the HbA1c mean values according to early-life and contemporary characteristics collected prospectively since birth. RESULTS: The distribution of the HbA1c was approximately normal in both cohorts, with a mean (SD) 5.10% (0.43) in the 1982 cohort, and 4.89% (0.50) in the 1993 cohort. HbA1c mean levels were significantly higher in individuals self-reported as black/brown skin color compared to those self-reported as white in both cohorts. Parental history of diabetes was associated with higher HbA1c mean in adults, while stunting at one year old presented an inverse relation with the outcome in adolescents. No other early and contemporary factors were associated with HbA1c levels in adults or adolescents. CONCLUSIONS: We found a consistent relationship between HbA1c and skin color in both cohorts. Further research is needed to understand the role of genomic ancestry on levels of HbA1c concentrations which may inform policies and preventive actions for diabetes mellitus and cardiometabolic risk.


Assuntos
Hemoglobina A Glicada/análise , Adolescente , Adulto , Fatores Etários , Brasil , Grupos de Populações Continentais/estatística & dados numéricos , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Fatores de Risco , Fatores Socioeconômicos
9.
Prog Cardiovasc Dis ; 58(6): 661-73, 2016 May-Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27041078

RESUMO

In Latin America, cardiovascular disease (CVD) mortality rates will increase by an estimated 145% from 1990 to 2020. Several challenges related to social strains, inadequate public health infrastructure, and underfinanced healthcare systems make cardiometabolic conditions and non-communicable diseases (NCDs) difficult to prevent and control. On the other hand, the region has high mobile phone coverage, making mobile health (mHealth) particularly attractive to complement and improve strategies toward prevention and control of these conditions in low- and middle-income countries. In this article, we describe the experiences of three Centers of Excellence for prevention and control of NCDs sponsored by the National Heart, Lung, and Blood Institute with mHealth interventions to address cardiometabolic conditions and other NCDs in Argentina, Guatemala, and Peru. The nine studies described involved the design and implementation of complex interventions targeting providers, patients and the public. The rationale, design of the interventions, and evaluation of processes and outcomes of each of these studies are described, together with barriers and enabling factors associated with their implementation.


Assuntos
Tecnologia Biomédica/tendências , Doenças Cardiovasculares/prevenção & controle , Doenças Metabólicas/prevenção & controle , Serviços Preventivos de Saúde/tendências , Telemedicina/tendências , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Prestação Integrada de Cuidados de Saúde/tendências , Difusão de Inovações , Previsões , Humanos , América Latina/epidemiologia , Doenças Metabólicas/diagnóstico , Doenças Metabólicas/epidemiologia , Fatores de Risco , Comportamento de Redução do Risco
10.
Glob Heart ; 11(1): 5-15, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27102018

RESUMO

Effectively tackling the growing noncommunicable disease (NCD) burden in low- and middle-income countries (LMIC) is a major challenge. To address research needs in this setting for NCDs, in 2009, National Heart, Lung, and Blood Institute (NHLBI) and UnitedHealth Group (UHG) engaged in a public-private partnership that supported a network of 11 LMIC-based research centers and created the NHLBI-UnitedHealth Global Health Centers of Excellence (COE) Program. The Program's overall goal was to contribute to reducing the cardiovascular and lung disease burdens by catalyzing in-country research institutions to develop a global network of biomedical research centers. Key elements of the Program included team science and collaborative approaches, developing research and training platforms for future investigators, and creating a data commons. This Program embraced a strategic approach for tackling NCDs in LMICs and will provide capacity for locally driven research efforts that can identify and address priority health issues in specific countries' settings.


Assuntos
Academias e Institutos , Pesquisa Biomédica , Países em Desenvolvimento , Saúde Global , National Heart, Lung, and Blood Institute (U.S.) , Parcerias Público-Privadas , Logro , Humanos , Estados Unidos
11.
Colomb. med ; 46(4): 168-175, Oct.-Dec. 2015. ilus
Artigo em Inglês | LILACS | ID: lil-774950

RESUMO

Introduction: The inadequate reporting of cross-sectional studies, as in the case of the prevalence of metabolic syndrome, could cause problems in the synthesis of new evidence and lead to errors in the formulation of public policies. Objective: To evaluate the reporting quality of the articles regarding metabolic syndrome prevalence in Peruvian adults using the STROBE recommendations. Methods: We conducted a thorough literature search with the terms "Metabolic Syndrome", "Sindrome Metabolico" and "Peru" in MEDLINE/PubMed, LILACS, SciELO, LIPECS and BVS-Peru until December 2014. We selected those who were population-based observational studies with randomized sampling that reported prevalence of metabolic syndrome in adults aged 18 or more of both sexes. Information was analysed through the STROBE score per item and recommendation. Results: Seventeen articles were included in this study. All articles met the recommendations related to the report of the study's rationale, design, and provision of summary measures. The recommendations with the lowest scores were those related to the sensitivity analysis (8%, n= 1/17), participant flowchart (18%, n= 3/17), missing data analysis (24%, n= 4/17), and number of participants in each study phase (24%, n= 4/17). Conclusion: Cross-sectional studies regarding the prevalence of metabolic syndrome in peruvian adults have an inadequate reporting on the methods and results sections. We identified a clear need to improve the quality of such studies.


Introducción: El reporte inadecuado de estudios transversales, como en el caso de la prevalencia de síndrome metabólico, podría causar problemas en la síntesis de nueva evidencia y generar errores en la formulación de políticas públicas. Objetivo: Evaluar la calidad de reporte de estudios transversales sobre la prevalencia de síndrome metabólico en Perú utilizando las recomendaciones de STROBE. Métodos: Se realizó una búsqueda bibliográfica exhaustiva hasta Diciembre 2014 en MEDLINE/PubMed, LILACS, SciELO, LIPECS y BVS-Perú con los términos "Metabolic Syndrome", "Sindrome Metabolico" y "Peru". Se seleccionaron estudios observacionales con base poblacional, muestreo aleatorizado, que reportaran datos de prevalencia en adultos mayores de 18 años de ambos sexos. La información fue analizada a través de STROBE según puntuación por artículo y por recomendación. Resultados: Diecisiete artículos fueron incluidos en este estudio. Todos cumplieron con las recomendaciones relacionadas con el reporte de razones y fundamentos de la investigación, reporte del diseño de estudio y la proporción de medidas de resumen. Las recomendaciones con menor puntaje fueron las relacionadas a la descripción del análisis de sensibilidad (8%, n= 1/13), consideración del uso de diagrama de flujo para los participantes (18%, n= 3/17), explicación del análisis de datos ausentes (24%, n= 4/17) y del número de participantes en cada fase (24%, n= 4/17). Conclusión: Los estudios transversales sobre prevalencia de síndrome metabólico en adultos del Perú presentan un inadecuado reporte en las secciones de métodos y resultados. Se identifica una clara necesidad de mejorar la calidad de este tipo de estudios.


Assuntos
Adulto , Humanos , Estudos Transversais/normas , Síndrome Metabólica/epidemiologia , Guias como Assunto , Estudos Observacionais como Assunto/normas , Prevalência , Peru/epidemiologia , Sensibilidade e Especificidade
12.
Colomb Med (Cali) ; 46(4): 168-175, 2015 Dec 30.
Artigo em Inglês | MEDLINE | ID: mdl-26848197

RESUMO

INTRODUCTION: The inadequate reporting of cross-sectional studies, as in the case of the prevalence of metabolic syndrome, could cause problems in the synthesis of new evidence and lead to errors in the formulation of public policies. OBJECTIVE: To evaluate the reporting quality of the articles regarding metabolic syndrome prevalence in Peruvian adults using the STROBE recommendations. METHODS: We conducted a thorough literature search with the terms "Metabolic Syndrome", "Sindrome Metabolico" and "Peru" in MEDLINE/PubMed, LILACS, SciELO, LIPECS and BVS-Peru until December 2014. We selected those who were population-based observational studies with randomized sampling that reported prevalence of metabolic syndrome in adults aged 18 or more of both sexes. Information was analysed through the STROBE score per item and recommendation. RESULTS: Seventeen articles were included in this study. All articles met the recommendations related to the report of the study's rationale, design, and provision of summary measures. The recommendations with the lowest scores were those related to the sensitivity analysis (8%, n= 1/17), participant flowchart (18%, n= 3/17), missing data analysis (24%, n= 4/17), and number of participants in each study phase (24%, n= 4/17). CONCLUSION: Cross-sectional studies regarding the prevalence of metabolic syndrome in peruvian adults have an inadequate reporting on the methods and results sections. We identified a clear need to improve the quality of such studies.


Assuntos
Estudos Transversais/normas , Síndrome Metabólica/epidemiologia , Adulto , Guias como Assunto , Humanos , Estudos Observacionais como Assunto/normas , Peru/epidemiologia , Prevalência , Sensibilidade e Especificidade
13.
Artigo em Inglês | MEDLINE | ID: mdl-27107284

RESUMO

UNLABELLED: Over the past 60 years Latin American countries have been experiencing noticeable demographic and socioeconomic changes, with marked impact on the population health in the region. There is growing recognition of the co-morbidity among mental and physical health problems impacting heavily on health care systems. These challenges open many opportunities for transformational change in the expanding field of global mental health. Given the growing evidence for the wide applicability and efficacy of specific components included in mental health treatment packages, research should focus more on improving the organization and efficiency with which we deliver these specific treatment components already proven to be efficacious. The Latin American Treatment and Innovation Network in Mental Health (LATIN-MH) is a research and training Hub based in Sao Paulo, Brazil, and Lima, Peru. It aims to address the co-morbidity between physical and mental chronic diseases, exploring the opportunity to use technology to support the treatment of these conditions. LATIN-MH strives to move beyond specific single-disease approaches and research silos, whilst maximizing the opportunities to work collaboratively with various groups in the Latin American region, thus contributing to fostering research and building capacity in mental health research. KEY WORDS: Mental Health, Chronic Disease, mHealth, Capacity Building (MeSH) Key concepts: Chronic diseases have now become the major determinants of the disease burden in Latin America, whereas psychiatric disorders accounted for almost one-third of years lived with disability worldwide in 2005. LATIN-MH is a research and training hub that aims to address the co-morbidity between physical and mental chronic diseases using technology to support their treatments. LATIN-MH strives to move beyond specific single-disease approaches and research siloes, whilst maximizing the opportunities to work collaboratively with various groups in the Latin American region, thus contributing to foster research and build capacity in mental health research. LATIN-MH is built on three driving principles: (i) building capacities to ensure sustainability and autonomy of mental health services, (ii) developing strategic interdisciplinary partnerships, and (iii) integrating mental health treatment into primary care and community health systems.


Assuntos
Transtornos Mentais/terapia , Serviços de Saúde Mental/tendências , Saúde Mental/tendências , Depressão , Humanos , Invenções , América Latina , Atenção Primária à Saúde , Fatores Socioeconômicos
16.
Rev Colomb Psiquiatr ; 42(1): 144-50, 2013 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-26572720

RESUMO

We present the case of a person with baseline Bipolar Affective Disorder, who starts receiving medical treatment for subclinical Hypothyroidism, during this time the patient develops Hyperthyroidism. During the course of the latter, the patient started to exhibit depressed mood symptoms and worsening of her baseline disorder. Typically there are depressive symptoms in hypothyroidism and manic symptoms in hyperthyroidism, there have been a few cases of depressive symptoms (depressed mood, asthenia and apathy) reported in patients with hyperthyroidism. Up till now it's a fact that Hyperthyroidism constitutes itself as a risk factor for developing or precipitating depressive states, thus increasing hospital readmissions, and another important fact is that of manifesting or worsening affective symptoms due to the influence of thyroid hormones. We also present the well-known relationship between thyroid malfunction and affective disorders.

17.
Rev. peru. med. exp. salud publica ; 29(3): 366-372, jul.- sept. 2012.
Artigo em Espanhol | PERNAL | ID: pnc-8393

RESUMO

El presente artículo busca describir, en contexto, los distintos procesos de cambio por el que transcurren, en la actualidad, nuestras sociedades y poblaciones a fin de comprender mejor la emergencia de las enfermedades crónicas no transmisibles en países de ingresos medios y bajos. Se describen aquellos factores relevantes para contextos específicos como el Perú, entre ellos migración interna, urbanización y los perfiles de adversidad en etapas tempranas de la vida, todos vinculados con enfermedades crónicas no transmisibles, incluyendo el sobrepeso y la obesidad. Se describe el modelo de “capacidad y carga”, el cual considera al riesgo de adquirir una enfermedad crónica no transmisible en la etapa adulta como una función de dos rasgos genéticos: capacidad metabólica y carga metabólica. Se presenta también la contribución de la migración rural-urbana a esta problemática en nuestro medio. Finalmente, se mencionan los retos pendientes en este tema para la salud pública del Perú(AU)


Assuntos
Humanos , Doença Crônica/prevenção & controle , Transição Epidemiológica , Transição Nutricional , Sobrepeso/prevenção & controle , Migração Interna , Migração Humana , Países em Desenvolvimento , Peru
18.
Int J Epidemiol ; 41(2): 557-71, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22407860

RESUMO

BACKGROUND: This article analyses the epidemiological research developments in Latin America and the Caribbean (LAC). It integrates the series commissioned by the International Epidemiological Association to all WHO Regions to identify global opportunities to promote the development of epidemiology. METHODS: Health situations of the regions were analysed based on published data on selected mortality, morbidity and risk factors. Epidemiological publication output by country was estimated by Medline bibliometrics. Internet and literature searches and data provided by key informants were used to describe perspectives on epidemiological training, research and funding. FINDINGS: Despite important advances in recent decades, LAC remains the world's most unequal region. In 2010, 10% of the LAC's people still lived in conditions of multidimensional poverty, with huge variation among countries. The region has experienced fast and complex epidemiological changes in past decades, combining increasing rates of non-communicable diseases and injuries, and keeping uncontrolled many existing endemic and emerging diseases. Overall, epidemiological publications per year increased from 160 articles between 1961 and 1970 to 2492 between 2001 and 2010. The increase in papers per million inhabitants in the past three decades varied from 57% in Panama to 1339% in Paraguay. Universities are the main epidemiological training providers. There are at least 34 universities and other institutions in the region that offer postgraduate programmes at the master's and doctoral levels in epidemiology or public health. Most LAC countries rely largely on external funding and donors to initiate and sustain long-term research efforts. Despite the limited resources, the critical mass of LAC researchers has produced significant scientific contributions. FUTURE NEEDS: The health research panorama of the region shows enormous regional discrepancies, but great prospects. Improving research and human resources capacity in the region will require establishing research partnerships within and outside the region, between rich and poor countries, promoting collaborations between LAC research institutions and universities to boost postgraduate programmes and aligning research investments and outputs with the current burden of disease.


Assuntos
Estudos Epidemiológicos , Bibliometria , Região do Caribe/epidemiologia , Países em Desenvolvimento , Epidemiologia/educação , Humanos , América Latina/epidemiologia , Morbidade/tendências , Mortalidade/tendências , Saúde Pública , Apoio à Pesquisa como Assunto , Fatores de Risco , Fatores Socioeconômicos
20.
Lancet ; 376(9734): 23-32, 2010 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-20554319

RESUMO

BACKGROUND: Tranexamic acid can reduce bleeding in patients undergoing elective surgery. We assessed the effects of early administration of a short course of tranexamic acid on death, vascular occlusive events, and the receipt of blood transfusion in trauma patients. METHODS: This randomised controlled trial was undertaken in 274 hospitals in 40 countries. 20 211 adult trauma patients with, or at risk of, significant bleeding were randomly assigned within 8 h of injury to either tranexamic acid (loading dose 1 g over 10 min then infusion of 1 g over 8 h) or matching placebo. Randomisation was balanced by centre, with an allocation sequence based on a block size of eight, generated with a computer random number generator. Both participants and study staff (site investigators and trial coordinating centre staff) were masked to treatment allocation. The primary outcome was death in hospital within 4 weeks of injury, and was described with the following categories: bleeding, vascular occlusion (myocardial infarction, stroke and pulmonary embolism), multiorgan failure, head injury, and other. All analyses were by intention to treat. This study is registered as ISRCTN86750102, Clinicaltrials.govNCT00375258, and South African Clinical Trial RegisterDOH-27-0607-1919. FINDINGS: 10 096 patients were allocated to tranexamic acid and 10 115 to placebo, of whom 10 060 and 10 067, respectively, were analysed. All-cause mortality was significantly reduced with tranexamic acid (1463 [14.5%] tranexamic acid group vs 1613 [16.0%] placebo group; relative risk 0.91, 95% CI 0.85-0.97; p=0.0035). The risk of death due to bleeding was significantly reduced (489 [4.9%] vs 574 [5.7%]; relative risk 0.85, 95% CI 0.76-0.96; p=0.0077). INTERPRETATION: Tranexamic acid safely reduced the risk of death in bleeding trauma patients in this study. On the basis of these results, tranexamic acid should be considered for use in bleeding trauma patients. FUNDING: UK NIHR Health Technology Assessment programme, Pfizer, BUPA Foundation, and J P Moulton Charitable Foundation.


Assuntos
Antifibrinolíticos/uso terapêutico , Transfusão de Sangue , Hemorragia/tratamento farmacológico , Trombose/prevenção & controle , Ácido Tranexâmico/uso terapêutico , Ferimentos e Lesões/complicações , Adulto , Feminino , Hemorragia/etiologia , Hemorragia/mortalidade , Hemorragia/terapia , Humanos , Masculino , Trombose/etiologia
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